Table of ContentsView AllTable of ContentsCausesSymptomsDiagnosisTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Causes
Symptoms
Diagnosis
Treatment
Frequently Asked Questions
Healthcare providers use a variety of blood tests, imaging procedures, and paracentesis to diagnose ascites. Treatment focuses on treating the underlying cause, if possible, and relieving symptoms.
This article reviews the symptoms, causes, diagnosis, and treatment of ascites.
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Benign(noncancerous) conditions can cause ascites.Liver failureor cirrhosis are the most common causes.Cirrhosis is scarring of the liver that occurs when a disease attacks and damages the liver.
While this is not an exhaustive list, diseases that can cause liver damage and lead to cirrhosis include:
How Common Is Ascites With CirrhosisAbout 60% of patients with cirrhosis get ascites within 10 years of their diagnosis.
How Common Is Ascites With Cirrhosis
About 60% of patients with cirrhosis get ascites within 10 years of their diagnosis.
Cancers that may spread to the abdomen (belly) and cause ascites include:
While mild ascites may cause no symptoms, more advanced ascites can become uncomfortable, creating a bloated or swollen appearance to the abdomen. Common symptoms of more advanced ascites include:
To diagnose ascites, your healthcare provider may perform the following tests:
ParacentesisA paracentesis is a procedure in which your healthcare provider uses a small needle to get a fluid sample from your abdomen.The fluid sample is then examined under a microscope. Specific characteristics of the fluid, like the presence of white blood cells, bacteria, or cancer cells, can help determine the cause of the ascites. This helps differentiate benign vs. malignant (cancerous) ascites.
Paracentesis
A paracentesis is a procedure in which your healthcare provider uses a small needle to get a fluid sample from your abdomen.The fluid sample is then examined under a microscope. Specific characteristics of the fluid, like the presence of white blood cells, bacteria, or cancer cells, can help determine the cause of the ascites. This helps differentiate benign vs. malignant (cancerous) ascites.
A paracentesis is a procedure in which your healthcare provider uses a small needle to get a fluid sample from your abdomen.
The fluid sample is then examined under a microscope. Specific characteristics of the fluid, like the presence of white blood cells, bacteria, or cancer cells, can help determine the cause of the ascites. This helps differentiate benign vs. malignant (cancerous) ascites.
The treatment of ascites depends on the cause. It also depends on the severity and is geared towards alleviating a person’s symptoms and making them more comfortable. Therapies include:
Therapeutic ParacentesisTherapeutic paracentesis is a relatively low-risk and effective procedure in which a large volume of fluid is removed from the abdomen. It’s not uncommon for someone with ascites to need regular paracentesis to remove the fluid.
Therapeutic Paracentesis
Therapeutic paracentesis is a relatively low-risk and effective procedure in which a large volume of fluid is removed from the abdomen. It’s not uncommon for someone with ascites to need regular paracentesis to remove the fluid.
If someone is experiencing refractory ascites, meaning it cannot be controlled well with traditional therapies, aperitoneovenousshunt may be placed surgically to drain fluid out of the abdomen.
This procedure comes with a higher risk and is not commonly performed. However, it can drastically improve the quality of life for those waiting for aliver transplant.
In the case of malignant ascites, a healthcare provider may consider cytoreductive surgery and chemotherapy administered directly into the abdomen called direct intraperitoneal chemotherapy. This is only considered for certain patients and requires a careful discussion with a healthcare provider to weigh the potential risks and benefits.
Summary
Symptoms include nausea, vomiting, feeling full when eating, loss of appetite, and shortness of breath. You could also experience fever or abdominal pain if an infection occurs in the fluid.
Various imaging procedures and possibly a paracentesis (draining fluid with a small needle) are used to diagnose ascites.
Treatment depends on the cause and may include restricting salt in your diet, diuretics (water pills), and therapeutic paracentesis. Cancer treatment such as chemotherapy or surgery may be needed if the underlying cause is malignant (cancerous). A peritoneovenous shunt and a liver transplant are other treatment possibilities. However, they are rare and only used when other treatments have stopped working.
A Word From Verywell
Frequently Asked QuestionsAscites is a symptom of an underlying health concern and requires medical attention. Left untreated, it can be fatal or life-threatening. It can cause infection, shortness of breath, pain, and swelling, leading to serious outcomes.Ascites is a common complication of end-stage liver disease.Ascites can be temporarily reversed with treatment. Permanent reversal depends on the underlying cause. If liver failure or cirrhosis is the cause, there is no cure, and managing ascites will require continual treatment. In rare cases, you may need a liver transplant.Research shows that 50% of those with ascites as a complication of end-stage renal disease (ESLD) will die within two to three years.When the ascites is refractory, meaning it is unmanageable and stops responding to treatment, six months is the average survival time. However, these are just averages and depend on many factors.
Ascites is a symptom of an underlying health concern and requires medical attention. Left untreated, it can be fatal or life-threatening. It can cause infection, shortness of breath, pain, and swelling, leading to serious outcomes.
Ascites is a common complication of end-stage liver disease.
Ascites can be temporarily reversed with treatment. Permanent reversal depends on the underlying cause. If liver failure or cirrhosis is the cause, there is no cure, and managing ascites will require continual treatment. In rare cases, you may need a liver transplant.
Research shows that 50% of those with ascites as a complication of end-stage renal disease (ESLD) will die within two to three years.When the ascites is refractory, meaning it is unmanageable and stops responding to treatment, six months is the average survival time. However, these are just averages and depend on many factors.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Gupta A, Sedhom R, Beg MS.Ascites, or fluid in the belly, in patients with cancer.JAMA Oncol.2020;6(2):308. doi:10.1001/jamaoncol.2019.5409Pedersen J, Bendtsen F, Møller S.Management of cirrhotic ascites.Ther Adv Chronic Dis. 2015;6(3):124–137. doi:10.1177/2040622315580069Sangisetty SL & Miner TJ. Malignant ascites: A review of prognostic factors, pathophysiology and therapeutic measures.World J Gastrointes Surg. 2012 Apr 27;4(4):87-95.
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